| NPI | 1225275035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1303) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 1242) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2020-06-26 |